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12 Athletes Leaving Brains to Concussion Study

N.F.L. players are lionized every Sunday for giving their bodies to the sport. Now, some retired players are planning to literally give their brains to a new center at Boston University’s School of Medicine devoted to studying the long-term effects of concussions.

A dozen athletes, including six N.F.L. players and a former United States women’s soccer player, have agreed to donate their brains after their deaths to the Center for the Study of Traumatic Encephalopathy.

On Thursday, the center will announce that a fifth deceased N.F.L. player, the former Houston Oilers linebacker John Grimsley, was found to have brain damage commonly associated with boxers.

The former New England Patriots linebacker Ted Johnson, one of the players who has agreed to donate his brain, said he hoped the center would help clarify the issue of concussions’ long-term effects, which have been tied to cognitive impairment and depression in several published studies. The N.F.L. says that, in regard to its players, the long-term effects of concussions are uncertain.

“I shouldn’t have to prove to anybody that there’s something wrong with me,” said Johnson, 35, whose neurologist has said multiple concussions from 2002 through his 2005 retirement resulted in permanent and degenerative problems with memory and depression.

Johnson added: “I’m not being vindictive. I’m not trying to reach up from the grave and get the N.F.L. But any doctor who doesn’t connect concussions with long-term effects should be ashamed of themselves.”

An N.F.L. committee is currently conducting its own study, as described in league news releases and a pamphlet distributed to players “to determine if there are any long-term effects of concussion in N.F.L. athletes.” On Tuesday, the league spokesman Greg Aiello said that the findings would probably be published in 2010.

In response to the Grimsley findings and the brain-donation program at Boston University, Aiello said: “We support all research that would further the scientific and medical understanding of this injury, which affects thousands of people, athletes and nonathletes alike, every year. Hundreds of thousands of people have played football and other sports without experiencing any problem of this type, and there continues to be considerable debate in the medical community on the precise long-term effects of concussions and how they relate to other risk factors.”

Grimsley died in February at 45 after he shot himself in the chest in what police ruled an accident. Subsequent analysis of his brain tissue confirmed the presence of neurofibrillary tangles that had already begun to affect Grimsley’s behavior and memory, said Dr. Ann C. McKee, an associate professor of neurology and pathology at the Boston University School of Medicine and a co-director of the new brain-study center.

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John Grimsley, right, was found to have chronic traumatic encephalopathy. Credit
Lou Witt/NFL

Of the six former N.F.L. players’ brains that have been examined in this manner, Grimsley’s was the fifth to be found to have chronic traumatic encephalopathy, joining the former Philadelphia Eagles defensive back Andre Waters and the former Pittsburgh Steelers Mike Webster, Terry Long and Justin Strzelczyk. (The condition can be confirmed only by post-mortem tissue analysis; X-rays and magnetic resonance imaging tests cannot yet detect it.) Because each player died relatively young, from 36 to 50, they provided an opportunity to examine brain abnormalities that are exceedingly rare in someone of that age without a history of repetitive brain injury.

The only former N.F.L. player whose brain did not show C.T.E. was the former running back Damien Nash, who died last year at 24 after collapsing while playing basketball. C.T.E., believed to result from trauma endured over many years, has almost never been found in anyone that young.

“I’ve seen thousands of brains of individuals with neurogenerative diseases and debilitating diseases,” McKee said. “I can say this is identical to the pugilistica dementia that I’ve seen in boxers in their 70s and 80s. It’s milder because the patients are younger. But once triggered, it seems to progress. The people that develop this disease, most of them show symptoms 10 or 20 years after retirement. It progresses inexorably until death.”

As each case of C.T.E. in a former player has come to light, N.F.L. officials have contended that they are isolated incidents from which no conclusions can be drawn, often because there are no documented medical histories of the players’ concussions in the N.F.L. or otherwise. Players at all levels of football are known to not reveal their concussions for fear of being removed from games or being seen as weak.

At a league conference on concussions in June 2007, Commissioner Roger Goodell pointed to the lack of concussion documentation from Strzelczyk’s career and said, “There’s no record he may have had a concussion swimming.” He added: “A concussion happens in a variety of different activities.”

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Chris Nowinski, of the Sports Legacy Institute sought brain tissue from John Grimsley.Credit
Jessica Kourkounis for The New York Times

McKee said that the five football cases constituted unequivocal evidence that on-field impacts were a primary cause of the damage, perhaps in association with genetic and other factors her program will attempt to identify.

“Yes, it’s only five cases,” said McKee, whose findings in the Grimsley examination were confirmed by Dr. E. Tessa Hedley-Whyte, the director of neuropathology at Massachusetts General Hospital. “But it’s also 100 percent of cases for something that is exceedingly rare in the average community dweller, if you want to look at it that way.”

Among the dozen living athletes, most with a history of concussions, who have agreed to donate their brains for examination after their deaths are the former N.F.L. players Johnson, Frank Wycheck, Isaiah Kacyvenski and Ben Lynch. Also participating are Noah Welch, who played hockey for the Florida Panthers last year, and Cindy Parlow, a former member of the United States national soccer team. All of them will be examined periodically so their concussion histories and any cognitive decline can be documented in detail.

The new Boston University center is being financed primarily by the university and a $100,000 grant from the National Institutes of Health, said Dr. Robert A. Stern, the program co-director along with McKee. It will operate in collaboration with the Sports Legacy Institute, a nonprofit organization founded last year by Chris Nowinski, the former Harvard University football player and professional wrestler, and Dr. Robert Cantu, a co-director of the Neurological Sports Injury Center at Brigham & Women’s Hospital in Boston.

“I’m doing this to raise awareness of concussion and the injury, because it’s so misunderstood,” said Parlow, 30, who competed in three Olympics and two World Cups for the United States team and now has severe headaches from two significant concussions. “You can’t say, ‘Look at my broken leg.’ It’s a hidden injury. Especially in female athletes, because it’s seen as a football or male injury.”

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Ex-Steeler Mike Webster was also found to have chronic traumatic encephalopathy.Credit
Gene J. Puskar/Associated Press

Nowinski, who called the families of Waters, Strzelczyk and Grimsley to request brain tissue from coroners, said he hoped that the brain-donation program would allow more brains — some with no concussion histories, for control purposes — to be more easily acquired for study by researchers both affiliated with and outside the center. He said that United States military veterans would also be approached so more could be learned about their battle injuries.

Grimsley’s widow, Virginia, said that she discussed concussions with her husband last year after news of their possible effects circulated in the news media.